Erosive Potential of Sugar Free and Sugar Containing Pediatric Medicines Given Regularly and Long Term to Children

Arora, Renu; Mukherjee, Utsav; Arora, Vivek

doi:10.1007/s12098-011-0543-5

Cited by 18 publications

(24 citation statements)

References 14 publications

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“…3,4,8,13 Many of these medicines, such as antibiotics and antihistamines, are usually used to treat children for long periods. 9 So, acidic medicines likely promote surface degradation of the tooth and increase dental roughness.…”

Section: Discussionmentioning

confidence: 99%

“…3,6,8,11,19,21 Nevertheless, the evaluation of these factors alone cannot determine whether a drug does have such potential.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies 1,4,8,11,14,22 evaluated various types of medications, taking into consideration their chemical components, pH, or titratable acidity. Some authors observed that Claritin ® had low endogenous pH, between 2.1 and 2.8, 8,22 and that Polaramine ® presented the highest pH value (6.0).…”

Section: 20mentioning

confidence: 99%

“…Some authors observed that Claritin ® had low endogenous pH, between 2.1 and 2.8, 8,22 and that Polaramine ® presented the highest pH value (6.0).…”

Section: 20mentioning

confidence: 99%

“…4 Certain properties of acidic products in general may be related to the loss of surface structure of dental enamel: low endogenous pH, high titratable acidity, and minimal quantities of minerals such as calcium or phosphate, in their compositions. 3,5,6,7,8 Acidic medications may cause dental erosion with loss of dental tissue. 1,4 Besides the presence of acids in some children's medications, other factors may also be related to changes in the surface morphology of dental enamel: high frequency of medication intake, bedtime consumption, high viscosity, and reduction in salivary flow.…”

Section: Introductionmentioning

confidence: 99%

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Do pediatric medicines induce topographic changes in dental enamel?

et al. 2016

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The purpose of the present study was to evaluate the effect of common pediatric liquid medicines on surface roughness and tooth structure loss and to evaluate the pH values of these medicines at room and cold temperatures in vitro. Eighty-four bovine enamel blocks were divided into seven groups (n = 12): G1-Aliviumand G7-Milli-Q water (negative control). The pH was determined and the samples were immersed in each treatment 3x/day for 5 min. 3D non-contact profilometry was used to determine surface roughness (linear Ra, volumetric Sa) and the Gap formed between treated and control areas in each block. Scanning electron microscopy (SEM) and energy dispersive spectrometry (EDS) were also performed. The majority of liquid medicines had pH ≤ 5.50. G1, G4, and G5 showed alterations in Ra when compared with G7 (p < 0.05). According to Sa and Gap results, only G5 was different from G7 (p < 0.05). Alteration in surface was more evident in G5 SEM images. EDS revealed high concentrations of carbon, oxygen, phosphorus, and calcium in all tested groups. Despite the low pH values of all evaluated medicines, only Alivium

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Section: Discussionmentioning

confidence: 99%

“…3,6,8,11,19,21 Nevertheless, the evaluation of these factors alone cannot determine whether a drug does have such potential.…”

Section: Discussionmentioning

confidence: 99%

Section: 20mentioning

confidence: 99%

“…Some authors observed that Claritin ® had low endogenous pH, between 2.1 and 2.8, 8,22 and that Polaramine ® presented the highest pH value (6.0).…”

Section: 20mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Do pediatric medicines induce topographic changes in dental enamel?

et al. 2016

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Oral Hygiene Products, Medications and Drugs - Hidden Aetiological Factors for Dental Erosion

Hellwig

Lussi

2014

Monographs in Oral Science

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Acidic or EDTA-containing oral hygiene products and acidic medicines have the potential to soften dental hard tissues. The low pH of oral care products increases the chemical stability of some fluoride compounds and favours the incorporation of fluoride ions in the lattice of hydroxyapatite and the precipitation of calcium fluoride on the tooth surface. This layer has some protective effect against an erosive attack. However, when the pH is too low or when no fluoride is present these protecting effects are replaced by direct softening of the tooth surface. Oral dryness can occur as a consequence of medication such as tranquilizers, antihistamines, antiemetics and antiparkinsonian medicaments or of salivary gland dysfunction. Above all, patients should be aware of the potential demineralization effects of oral hygiene products with low pH. Acetyl salicylic acid taken regularly in the form of multiple chewable tablets or in the form of headache powder, as well as chewing hydrochloric acids tablets for the treatment of stomach disorders, can cause erosion. There is most probably no direct association between asthmatic drugs and erosion on the population level. Consumers and health professionals should be aware of the potential of tooth damage not only by oral hygiene products and salivary substitutes but also by chewable and effervescent tablets. Several paediatric medications show a direct erosive potential in vitro. Clinical proof of the occurrence of erosion after use of these medicaments is still lacking. However, regular and prolonged use of these medicaments might bear the risk of causing erosion. Additionally, it can be assumed that patients suffering from xerostomia should be aware of the potential effects of oral hygiene products with low pH and high titratable acidity.

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Sugar content and erosive potential of commonly prescribed Orodispersible tablets- An in vitro study.

et al. 2023

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Background: Dental caries is a major non-communicable disease of public health concern caused due to freely available dietary sugars. We aimed to compare the sugar content and erosive potential with duration of use and drug classes of orodispersible tablets (ODTs). Methods: We conducted an in vitro evaluation of the total sugar content (TSC), Potential of Hydrogen (pH), solubility, and Titratable Acidity (TA) of commonly prescribed 62 ODTs. TA was measured by titrating the samples with known amount of. 0.1N sodium hydroxide (NaOH) with phenolphthalein indicator and pH was determined by digital pH meter. TSC was evaluated by phenol sulphuric acid. Solubility was assessed by filtration. Results: Out of the 62 ODTs, majority were Antimicrobials (n=30). One-quarter of the ODTs (26%) had a mean pH below ≤5.5. No significant difference was seen in the mean pH with respect to different drug classes (p=0.082) and duration of use of ODTs. A significant difference was seen in the mean percentage solubility with respect to drug classes (p<0.001). Antimicrobials had the least percentage of solubility as compared to other drug classes. Antiemetics and proton pump inhibitors (24.33 ± 17.34) had significantly higher mean percentage sugar content than Antimicrobials (23.25 ± 17.16). No significant difference was seen in the mean TSC with respect to various drug classes (p=0.718) and between the duration of use of drugs (P=0.568) respectively. No significant difference was seen in the mean percentage TA with respect to drug class (p=0.123) and duration of use of drugs (p=0.424). Conclusion: Overall, we can conclude that one in four ODT formulations had a pH below 5.5 (critical pH). Only one ODT formulation did not have a sugar content. No difference was seen in the mean pH, sugar content, and TA with respect to duration of use of drugs and drug classes.

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Erosive Potential of Sugar Free and Sugar Containing Pediatric Medicines Given Regularly and Long Term to Children

Abstract: Pediatric SF medicines were not more erosive than SC medicines in vitro; a more significant predictor of their erosive potential was dose form. Higher the dose form more was the erosive potential of the medicine.

Cited by 18 publications

References 14 publications

Do pediatric medicines induce topographic changes in dental enamel?

Do pediatric medicines induce topographic changes in dental enamel?

Oral Hygiene Products, Medications and Drugs - Hidden Aetiological Factors for Dental Erosion

Sugar content and erosive potential of commonly prescribed Orodispersible tablets- An in vitro study.

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